Testosterone Benefits and Risks by Jeffrey Dach MD

Jeffrey Dach, M.D. NewsLetter


Dear ,

I recently received the follwing email message from a friend who subscribes to this newsletter.

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Does Testosterone Cause Prostate Cancer ?
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Hi Jeff--

I hope you, the family are doing well. Thanks for having me on your e-mail list for your newsletter.

I believe that you are right on target with health and nutrition. We have already practice many of the ideas you mention. My wife was trained as a Clinical Nutritionist with a M.S. in Clinical Nutrition from NYU.

She is a follower of Dr. Andrew Weil. We are always researching and reading up on nutrition and try to stay away from drugs if possible and treat any issue naturally with the proper nutrients. You are right on target when it comes to explaining the emergence of insulin resistance from eating refined carbohydrates. Most people do not understand this. Next time we are in Miami, we can have fun talking about all these issues.

I am also fascinated by your involvement in bioidentical hormone therapy.

I suppose it would be interesting to walk into a Quest lab and take all the appropriate tests for men of our age group. The main issue I have with hormone therapy and boosting testosterone levels is perhaps the history of its lack of long term usage , and I have read that it is possible that it could increase cancer risk. I was wondering what your thoughts are on this.

Sincerely, Alan


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My reply to Alan (see below):


Dear Alan,

The statement that there is a lack of long term use for Testosterone is simply false: This is a myth. The Nobel Prize was awarded in 1939 for the synthesis of testosterone (read about it here). And, testosterone has been studied for over 70 years with massive amounts of research showing numerous health benefits.

Benefits of Testosterone Therapy:

Benefits include positive effects on mood, energy levels, verbal fluency, strength, increased muscle size, decreased body fat and increased bone density. There is also an anti-depressant effect.

Here are a few of these studies showing testosterone is good for the Heart and Circulation:

Dr. S. Dobrzycki studied men with known coronary artery disease and showed they had significantly lower levels of testosterone (J Med Invest 2003). He also showed that lower testosterone levels was associated with reduced pumping ability of the heart.

Dr. C.J. Malkin showed that testosterone therapy reduced the risk of death from abnormal heart rhythms (arrhythmias). This was published in the American Journal of Cardiology in 2003. Dr Malkin also reported that Testosterone acts a protective factor against atherosclerosis and plaque formation in arteries (J Endocrin 2003).

Dr. Gerald Philips at Columbia University, and Dr. Joyce Tenover of the University of Washington also showed that low testosterone correlates with increased heart disease. These are only a few of the many recent articles.

Dr. Eugene Shippen presented an impressive study at a recent meeting I attended, in which testosterone therapy was used to successfully reverse diabetic gangrene of the lower legs and avoid amputation in many cases.

For more information see my testosterone page.

Regarding your question of Prostate Cancer risk from testosterone, there is no evidence for this in the medical literature (see below).

Here are only three of the many medical literature references showing no evidence that testosterone causes prostate cancer:

(1) Testosterone replacement therapy and prostate risks: where's the beef? Morgentaler A. Can J Urol. 2006 Feb;13 Suppl 1:40-3. Division of Urology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

"It has been part of the conventional medical wisdom for six decades that higher testosterone in some way increases the risk of prostate cancer. This belief is derived largely from the well-documented regression of prostate cancer in the face of surgical or pharmacological castration. However, there is an absence of scientific data supporting the concept that higher testosterone levels are associated with an increased risk of prostate cancer. Specifically, no increased risk of prostate cancer was noted in 1) clinical trials of testosterone supplementation, 2) longitudinal population-based studies, or 3) in a high-risk population of hypogonadal men receiving testosterone treatment. Moreover, hypogonadal men have a substantial rate of biopsy-detectable prostate cancer, suggesting that low testosterone has no protective effect against development of prostate cancer. These results argue against an increased risk of prostate cancer with testosterone replacement therapy."

(2) Monitoring androgen replacement therapy: testosterone and prostate safety. Morales A. J Endocrinol Invest. 2005;28(3 Suppl):122-7

"The aging of the world population has brought to the forefront of medical practice the diagnosis and treatment of hypogonadism in adult men. There is an increasing interest on the use of testosterone (T) and other androgens to manage men with clinical and biochemical evidence of hypogonadism. Although treatment with T has been used for 70 yr and it is, generally, safe and effective, there are a number of safety issues--ranging from cardiovascular and lipid alterations to hematological changes--that the physician needs to be aware of. Unquestionably, prostate safety constitutes the most important one. No evidence exists that appropriate androgen administration with knowledgeable monitoring carries significant or potentially serious adverse effects on the prostate gland. Men with symptomatic lower urinary obstruction need to be assessed carefully prior to androgen administration. The suspicion of prostate cancer is an absolute contraindication for T use. Recommendations are available for the judicious and safe use of T in aging men."

(3) Risks of Testosterone-Replacement Therapy and recommendations for Monitoring. N Engl J Med 2004;350:482-92. Rhoden and Morgentaler

�Despite decades of research, there is no compelling evidence that testosterone has a causative role in prostate cancer.�

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Testosterone Questionnaire
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Now that we have determined that testosterone is safe to use and does not cause prostate cancer, can we determine with a questionnaire if there is a low testosterone lever?

Yes, this is the Questionnaire:

The ADAM Male questionnaire about symptoms of low testosterone (Androgen Deficiency in the Aging Male).

1. Do you have a decrease in libido (sex drive)? Yes No

2. Do you have a lack of energy? Yes No

3. Do you have a decrease in strength and/or endurance? Yes No

4. Have you lost height? Yes No

5. Have you noticed a decreased "enjoyment of life" Yes No

6. Are you sad and/or grumpy? Yes No

7. Are your erections less strong? Yes No

8. Have you noticed a recent deterioration in your ability to play sports? Yes No

9. Are you falling asleep after dinner? Yes No

10. Has there been a recent deterioration in your work performance? Yes No

If you answered YES to questions 1 or 7 or any 3 other questions, you may have low testosterone.

Next step is a testosterone blood test to determine your level. If low, then testosterone supplementation may be considered.

What about low testosterone in women?

This can cause dry eyes. Read about Testosterone for dry eyes in Sjogren's syndrome: (4 ) (5 )

Warmest Regards from, Jeffrey Dach, M.D.

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My Recent Articles
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(click on the number)

(1) Lipitor and "The Dracula of Modern Technology"

(2) Osteoporosis, Bisphosphonate Drugs and Toulouse Lautrec

(3) Prozac, PAxil and SSRI Drugs - Part One

(4) Prozac, Paxil and SSRI Drugs - Part Two

(5) Max Essex and Virological Failure in the NEJM

(6) The Origins of HIV

A Medical Article that I Published in 1980:

(7) Dach J, Patel N, Patel S, Petasnick J. Peritoneal mesothelioma: CT, sonography, and gallium-67 scan. AJR Am J Roentgenol. 1980 Sep;135(3):614

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Recent Patient Testimonials

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This is a recent testimonial from a patient with low thyroid (Hashimoto's Thyroiditis):

�I highly recommend Dr. Dach to anyone that is frustrated with thyroid issues. For years I bounced from doctor to doctor - each giving me prescriptions for levoxyl and cytomel. Even when my test results wouldn't budge below 5, they wouldn't prescribe higher doses because I was "within range" and "too high a dose will cause osteoporosis later". Who cares when I can't get out of bed now?!

Dr. Dach was recommended by a friend and he's been a lifesaver. He spent over an hour with me on my first appointment (I have Hashimoto's) and switched me to a bio-identical (Nature-Thyroid) in addition to testing my vitamin D levels (I was severely deficient). Not only does he listen, he opened my eyes to a lot of issues that all of my other doctors never even mentioned.

I've been going to him for about a year now and the change has been nothing short of amazing - I can get out of bed and be a functional human whose hair isn't falling out! He is kind and caring and highly informative.

I highly recommend Dr. Dach to anyone frustrated with their current treatment! He will make you feel well!�

signed LowThyroid

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Here is recent testimonial from a grateful patient started on bio-identical hormone treatment:

" After seeing Dr. Dach, I recently started bio-identical hormone medication because I was very depressed and anxious. Additionally, my memory was failing me throughout the day. I was ill equipped to function as a stay-at-home Mom with three small children.

After getting on the correct dosage with Dr. Dach's help it is truly amazing how quickly I felt like myself again! My world went from a very dark place to a bright light! It was so wonderful to feel happy again!!! Thank you so much Dr. Dach for everything!

My deepest gratitude,

Signed GratefulPatient"

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Don't forget to visit my web site for more information, and we you might like to attend one of our free seminars on Wednesday Nights. Please call for reservations for the seminar, though.

Do you have a testimonial, or a question for the newsletter? Send it in via email reply.

Sincerely Yours and Happy Purim,
Jeffrey Dach, M.D.
4700 Sheridan Suite T.
Hollywood, Fl 33021
954-983-1443

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Dr. Dach is Board Certified by the American Board of Radiology and a member of the Board of the American Academy of Anti-Aging Medicine. He has 25 years experience in the Memorial Hospital System. His practice focuses on Bio-identical hormone supplementation for men and women, natural thyroid and the use of natural substances rather than drugs in the appropriate setting.
(c) 2007 Jeffrey Dach MD All Rights Reserved. disclaimer

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